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Bioethics 101

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June 30, 2008

AMA Supports Palliative Sedation–As it Should

The AMA has officially supported palliative sedation. This should be able to go without saying. But due to assisted suicide advocates trying to turn palliative sedation into “terminal” sedation, confusion has arisen. In any event, from the story in the American Medical News:

When all else fails to control patients’ pain at the end of life, it is appropriate for physicians to sedate such patients to unconsciousness, according to new ethical policy adopted at the AMA Annual Meeting in June.

The rarely employed practice of palliative or terminal sedation is sometimes perceived as speeding the dying process, leading critics to dub it a form of physician-assisted suicide. But evidence of such a hastening effect is lacking, according to a Council on Ethical and Judicial Affairs report adopted by the House of Delegates. “These are unusual circumstances that require us to urgently relieve these symptoms by sedating patients to unconsciousness,” said CEJA member H. Rex Greene, MD, a Lima, Ohio, oncologist and palliative medicine specialist. “This is not intended to end life.”

Key words: “When all else fails,” and “rarely employed process,” and, “this is not intended to end life.”

I know Rex Greene and he is a powerful voice against assisted suicide and euthanasia. And his quote is absolutely true. But the article should have added that any confusion that may exist about palliative sedation was not caused by opponents of assisted suicide. Rather proponents intentionally sowed confusion by–as in California’s AB 2747 before it was gutted in committee–seeking to pass legislation that would transform it from a rarely used but legitimate palliative measure into a “treatment” available to all terminally ill patients on demand–whether their symptoms warranted it or not.

Palliative sedation, as described in the article, is proper and ethical. But if euthanasia advocates get their way, it would become a form of back-door assisted suicide/euthanasia–as now appears to be the case in the killer country the Netherlands where doctors increasingly use sedation so they don’t have to be at the bedside when they euthanize the patient. They should cease and desist their redefinition attempts now for the benefit of all of us.

Your Medical Data Online

Google and Microsoft are offering rival programs that let people manage their own health information. (Technology Review)

The Ethics of Testing Embryos for Disease

A London doctor used genetic screening to help a woman conceive Britain’s first baby guaranteed to be free of hereditary breast cancer. (ABC News)

Weighing the Costs of a CT Scan’s Look Inside the Heart

A group of cardiologists recently had a proposition for Dr. Andrew Rosenblatt, who runs a busy heart clinic in San Francisco: Would he join them in buying a CT scanner, a $1 million machine that produces detailed images of the heart? (New York Times)

A Stem Cell Treatment Without Controversy

Harman, a self-described biotechnology entrepreneur, is the founder of Vet-Stem, Inc., a Poway company using fat-derived adult stem cells to treat horses, dogs and cats with ligament tears, bowed tendons, fractures and joint disease. (Voice of San Diego)

South African TB patients rampage

Authorities increased security Friday at a tuberculosis hospital where patients with drug-resistant forms of the disease went on a rampage to protest prison-like conditions. (Associated Press)

Improved Technique Makes it Easier to Form Powerful Stem Cells

A new method may allow scientists to reduce the risk of cancer as they turn adult stem cells to a more powerful, embryonic-like state, according to a study in mice. (Bloomberg)

June 27, 2008

A New Issue of Pain Medicine is Now Available

Pain Medicine (OnlineEarly) is now available by subscription only.

Articles include:
“Toward a More Empathic Relationship in Pain Medicine” by John D. Banja, PhD, 18-Jun-2008
“Complementary and Alternative Medicine Use by Primary Care Patients with Chronic Pain” by Eric I. Rosenberg, MD, MSPH, Inginia Genao, MD, Ian Chen, MD, MPH, Alex J. Mechaber, MD, Jo Ann Wood, MD, MSEd, Charles J. Faselis, MD, James Kurz, MD, Madhu Menon, MD, Jane O’Rorke, MD, Mukta Panda, MD, Mark Pasanen, MD, Lisa Staton, MD, Diane Calleson, PhD, and Sam Cykert, MD, 18-Jun-2008
“Ethical Decision-Making: Do Anesthesiologists, Surgeons, Nurse Anesthetists, and Surgical Nurses Reason Similarly?” by Alex Cahana, MD, DAAPM, FIPP, MEthics, Henrik Weibel, MAS, and Samia A. Hurst, MD, 30-Jul-2007

A New Issue of Sociology of Health & Illness is Now Available

Sociology of Health & Illness (OnlineEarly) is now available by subscription only.

Articles include:
“New reproductive technologies, genetic counselling and the standing of the fetus: views from Germany and Israel” by Yael Hashiloni-Dolev and Noga Weiner, 19-Jun-2008
“Men, masculine identities, and health care utilisation” by Jack H. Noone and Christine Stephens, 18-Jun-2008
“Approaches to methadone treatment: harm reduction in theory and practice” by Margaretha Järvinen, 18-Jun-2008
“Towards a sociology of disease” by Stefan Timmermans and Steven Haas, 18-Jun-2008
“Waking up to sleepiness: Modafinil, the media and the pharmaceuticalisation of everyday/night life” by Simon J. Williams, Clive Seale, Sharon Boden, Pam Lowe and Deborah Lynn Steinberg, 28-Apr-2008
“The embryo as moral work object: PGD/IVF staff views and experiences” by Kathryn Ehrich, Clare Williams and Bobbie Farsides, 28-Apr-2008
“Biomedicine, holism and general medical practice: responses to the 2004 General Practitioner contract” by Kath Checkland, Stephen Harrison, Ruth McDonald, Suzanne Grant, Stephen Campbell and Bruce Guthrie, 28-Apr-2008

A New Issue of Aging Cell is Now Available

Aging Cell (OnlineEarly) is now available by subscription only.

Articles include:
“Stem Cell Review Series: Aging of the skeletal muscle stem cell niche” by Suchitra D. Gopinath and Thomas A. Rando, June 17, 2008
“Stem Cell Review Series: Regulating highly potent stem cells in aging: environmental influences on plasticity” by Jay M. Edelberg and Victoria L. T. Ballard, June 17, 2008

Umbilical Cord Blood Cell Transplants May Help ALS Patients

A study at the University of South Florida has shown that transplants of mononuclear human umbilical cord blood (MNChUCB) cells may help patients suffering from Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease. A disease in which the motor neurons in the spinal cord and brain degenerate, ALS leaves its victims with progressive muscle weakness, paralysis and, finally, respiratory failure three to five years after diagnosis. (ScienceDaily)

La. Gov. Jindal signs cloning bill

Governor Bobby Jindal has signed into law legislation that would ban government funding in Louisiana for what is sometimes called “therapeutic cloning.” (Houma Today)

Genetic-Testing Fight Continues

Direct-to-consumer genetic-testing companies who were served cease-and-desist letters by the state of California responded this week. Some insisted that they are in compliance with state laws, and others closed their doors to Californians. Both 23andMe and Navigenics, two high-profile, California-based startups offering a new breed of genome-wide screening services, say that they will continue to operate in the state. (Technology Review)

Stem-Cell Treatments for Pets

Unlike these older, more popular therapies, Vet-Stem offers — for the time being — better medicine to animals than any allowed for their owners: even though it does not use controversial embryonic stem cells, the fatty-tissue stem-cell transplant has not yet secured FDA approval for use in humans. But pets are reaping the benefits in droves. (TIME)

UK: Move to attract pharmaceutical research to NHS

Prime Minister Gordon Brown has announced that five to ten academic health science centres will be established. It will see teaching hospitals working alongside university research departments to “benefit each other in the years to come”. (UKTI Today)

WARF stem cell patents officially affirmed

The United States Patent and Trademark Office has issued Re-examination Certificates for the two most important base embryonic stem cell patents held by the Wisconsin Alumni Research Foundation (WARF). (Capital Times)

The Fight to End Aging Gains Legitimacy, Funding

This weekend, The Methuselah Foundation, is sponsoring its first U.S. conference on the emerging interdisciplinary field that [Aubrey] de Grey has helped kick start. (Its first day, Friday, will be free and open to the public.) The conference, Aging: The Disease – The Cure – The Implications, held at UCLA, is an indication of how far de Grey has come in mainstreaming his ideas. (Wired)

UK: ‘One egg’ IVF strategy launched

Fertility experts have called for a dramatic cut in the number of twins born after IVF treatment.

IVF clinics in the UK will be expected to reduce the number of multiple births from a national average of one in four to 10% over the next three years. (BBC)

Australia: Euthanasia issue lives again

FEDERAL Parliament could soon find itself grappling once more with euthanasia after the leaders of both major parties gave permission for a conscience vote on the issue. (Sydney Morning Herald)

Op-Ed: Cash for kidneys? Scheme won’t work

Whether for religious or cultural reasons, some Americans don’t like mixing money and body parts. Some just don’t trust the health care system and fear being rushed off to their maker prematurely if they indicate a willingness to be a donor — a fear not likely to be assuaged if paying for organs makes people worth more dead than alive. (MSNC)

India: Proxy womb law set for birth

The government is thinking of enacting a law to regulate surrogacy in a bid to make the deal struck between the prospective parents and the woman lending her womb legally binding on both sides. (The Telegraph)


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